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肝静脉闭塞病

肝静脉闭塞病的相关文献在1992年到2021年内共计81篇,主要集中在临床医学、内科学、肿瘤学 等领域,其中期刊论文72篇、会议论文8篇、专利文献74812篇;相关期刊58种,包括中华保健医学杂志、中国实验血液学杂志、国际输血及血液学杂志等; 相关会议4种,包括第十七届全国小儿血液病学术会议、中华骨髓库第四届年会、浙江省医学会成立70周年纪念大会暨2002年浙江省内科系统学术交流会等;肝静脉闭塞病的相关文献由291位作者贡献,包括徐开林、曾令宇、刘迷迷等。

肝静脉闭塞病—发文量

期刊论文>

论文:72 占比:0.10%

会议论文>

论文:8 占比:0.01%

专利文献>

论文:74812 占比:99.89%

总计:74892篇

肝静脉闭塞病—发文趋势图

肝静脉闭塞病

-研究学者

  • 徐开林
  • 曾令宇
  • 刘迷迷
  • 化静
  • 安立才
  • 何岳林
  • 吴学东
  • 房婷
  • 李春富
  • 冯四洲
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 方媛; 潘惠安; 韦春荔
    • 摘要: 目的:探讨造干血细胞移植(HSCT)并发肝静脉闭塞病(VOD)的护理对策.方法:选取我院(2019年1月~2020年9月)收治20例行HSCT治疗的地中海贫血患儿,分析HSCT治疗VOD发病情况,总结护理措施.结果:20例患儿,17例正常,3例并发VOD,其中1例因急性溶血死亡,剩余2例好转.结论:HSCT前应警惕患儿有无高危因素,术后做好症状护理、仪器监护、导管护理、用药护理、心理护理是防治VOD的有效措施.
    • 赖小璇; 李桥川
    • 摘要: 肝静脉闭塞病(VOD/SOS)是造血干细胞移植(HSCT)的严重并发症之一,重症患者死亡率高,临床以黄疸、腹水、体重增加、肝大及肝区疼痛为主要表现,诊断主要依据临床表现及相关实验室检查.积极的预防、早期诊断和恰当的治疗可降低其发生率和死亡率.
    • 王晓宁; 姚建娜; 孙春红; 郭彩利; 习杰英; 贺鹏程; 张梅
    • 摘要: Objective To investigate the influences of donor HBV infection on allogeneic hematopoietic stem cell transplantation recipients.Methods We made a retrospective analysis of data of four patients without HBV infection who underwent allogeneic hematopoietic stem cell transplantation from January 2015 to December 2016. Among them donors of these patients all had HBV infection.We then observed the influences of HBV infection on hematopoietic reconstruction,hepatic vein occlusive disease and HBV infection.Results HBV serological conditions of two donors were HbsAb,HbeAb and HbcAb positive,and quantitative of HBV-DNA was negative;the donor and the recipient did not use anti-HBV drugs.One donor was HbsAg,HbeAb and HbcAb positive,and the quantitative of HBV-DNA was also positive.Another donor was HbsAg and HbcAb positive,and the quantitative of HBV-DNA was also positive.These two donors received oral nucleoside therapy one month before stem cell collection and the recipients of these two donors also took nucleoside drugs one week before the conditioning.Hepatitis B immune globulin was given after transfusion of stem cells and the third day and seventh day after transplantation.Quantitative of HbsAb was detected each month and if it was less than 150 IU,hepatitis B immune globulin would be given.All the recipients had hematopoietic reconstruction and no VOD or hepatitis B virus infection occurred.Conclusion Oral administration of nucleoside drugs combined with hepatitis B immunoglobulin can effectively prevent HBV infection in recipients with HBV infection donors.%目的 观察供者乙肝病毒(HBV)感染对异基因造血干细胞移植受者的影响.方法 回顾性分析我院2015年1月至2016年12月期间行异基因造血干细胞移植的4例非乙肝患者,其供者均有HBV感染.观察应用 HBV感染供者的外周血造血干细胞进行移植,移植后对受者造血重建、肝静脉闭塞病(VOD)以及 HBV感染的影响.结果 4例供者中2例供者为乙肝血清学HbsAb、HbeAb及HbcAb阳性,HBV-DNA定量阴性,供受者均未应用抗 HBV药物.1例供者为 HbsAg、HbeAb及 HbcAb阳性,HBV-DNA定量阳性;1例供者 HbsAg及 HbcAb阳性,HBV-DNA定量阳性.这2例供者移植前1个月开始口服核苷类药物治疗,移植前 HBV-DNA定量转为阴性,受者预处理前1周开始口服核苷类药物预防 HBV感染,回输干细胞当天及回输后第3天及第7天均给予乙肝免疫球蛋白,移植后每月复查HbsAb定量,低于150 IU给予输注乙肝免疫球蛋白.4例患者移植后均造血重建,无1例发生VOD,截止随访结束均无HBV感染,监测HBV-DNA定量阴性.结论 对于HBV复制的供者及其受者口服核苷类抗 HBV药物联合乙肝免疫球蛋白可以有效预防受者HBV感染.
    • 敖康健; 柯昌征; 丁德平; 马德强; 张银华; 孟忠吉; 陈悦
    • 摘要: Objective To discuss clinical experiences in the diagnosis of fifteen patients with hepatic veno-occlusive disease (HVOD). Methods The clinical data from 15 patients with hepatic veno-occlusive disease were analysed retrospectively. Results According to the results of the imaging examination and the clinical data, the CT scans showed increased liver volume and homogeneously or inhomogeneously decreased liver parenchyma density, and the enhancement scans showed map -shaped enhancement, especially in the portal phase. The hepatic veins and the hepatic segment of the inferior vena cava appeared thinner, and the hepatic vein could not be seen clearly. The characteristic histological changes included hepatic congestion, sinusoidal dilatation, and hepatocyte necrosis. Conclusion Liver biopsy is significantly valuable in the assessment of HVOD. Dynamic enhanced CT is an efficient method for the diagnosis of hepatic veno-occlusive disease.%目的 探讨肝小静脉闭塞病(hepatic veno-occlusive disease,HVOD)的诊断方法.方法 回顾性分析本院2010年~2015年确诊HVOD的15例肝小静脉闭塞病的临床和病理资料.结果 15例患者CT平扫表现为肝脏增大,肝实质密度均匀减低,增强呈"地图状"强化,门脉期明显;肝静脉及下腔静脉肝段变细,肝静脉显示欠清晰.病理学表现为肝窦淤血、扩张,肝细胞出现不同程度变性、坏死.结论 病理检查对确诊肝小静脉闭塞病影像诊断有重要价值,CT增强检查是诊断肝小静脉闭塞病的有效方法.
    • 刘艳
    • 摘要: 目的 对患者行造血干细胞移植术后并发中重度肝静脉闭塞病的临床护理方法及效果展开探究.方法 选取来我院接受造血干细胞移植治疗的80例患者为例,对其中3例并发肝静脉闭塞病的患者展开心理护理、症状护理、仪器监护以及用药指导等护理操作,观察并统计护理效果.结果 患者造血干细胞移植术后并发中重度肝静脉闭塞的发生率为3.75%(3/80),其中,病情程度为重度的2例患者在术后的65 d及72 d死亡,为中度的1例患者经过治疗后得到痊愈.结论 在对患者施行造血干细胞移植手术之前,医护人员应仔细检查其是否存在高危因素;而在手术结束后,则做好相应的护理干预,从而有效避免肝静脉闭塞病的发生.
    • 康慧珠; 郑晓丽; 王志东; 韩冬梅; 丁丽; 王恒湘
    • 摘要: 目的:探讨单倍体相合造血干细胞移植(haploidentical HSCT,hi-HSCT)后迟发性肝静脉闭塞病(VOD)的发病率、致病因素、临床特征、治疗及预后.方法:回顾性分析我院208例接受单倍体造血干细胞移植术的患者的临床资料.结果:208例中6例患者发生移植后VOD,其发病率约为2.88%;6例患者均为迟发性VOD,中位时间为移植后44.5(30-57)d,其中4例为中度,2例为重度.2例患者因病情迅速进展和并发多脏器功能衰竭(MOF)而死亡,4例患者及时给予以去纤苷为主的联合治疗后均得到控制症状,其中1例长期存活,1例患者骨髓复发,余2例因继发肝脏急性移植物抗宿主病(aGVHD)而死亡.结论:炔诺酮用药史为VOD发生的危险因素.未发现性别、年龄及原发病危险度与VOD发生有关.小剂量普通肝素预防能显著降低VOD发病率.VOD的发生时间推迟可能与移植前肝脏储备功能、预处理中白消安剂量及移植相关用药有关,迟发VOD的预后可能较早期VOD更差.尚需更大样本量的研究以探讨hi-HSCT后迟发VOD的发生率及影响因素.去纤苷能显著提高VOD患者100d生存率.
    • 黄玉金
    • 摘要: Hepatic veno-occlusive disease (HVOD) is one of the serious liver injury complications,and typical HVOD generally occurred within one month after hematopoietic stem cell transplantation (HSCT).The mechanism of HVOD is not entirely clear so far,and inflammation is one of the common factors affecting the HVOD.Inflammation is a response characteristic for injury,which depends on the innate immune cell activating and secreting interleukin (IL)-1α,-1β and tumor necrosis factor (IFN)-α.The inflammasome is the platform for proinflammatory cytokine hydrolysis activation,and determines the inflammatory injury degree.This review expounds research progress of inflammasomes in liver damage after HSCT.%肝静脉闭塞病(HVOD)是造血干细胞移植(HSCT)后的严重肝脏损伤并发症,典型HVOD一般发生在HSCT后1个月内.HVOD的发生机制迄今尚未完全清楚,其中炎症是影响HVOD的常见因素之一.炎症是以固有免疫细胞活化、分泌白细胞介素(IL)-1α,-1β及肿瘤坏死因子(TNF)-α等促炎因子为特征的损伤性反应,而炎性复合体是促炎因子水解活化的蛋白平台,可间接影响炎性损伤程度.笔者拟就炎性复合体在HSCT后HVOD发生中的研究进展进行综述如下.
    • 王晓宁; 刘华胜; 王怀宇; 刘海波; 郭彩利; 孙春红; 张梅; 贺鹏程; 刘心; 陈丽梅; 王梦昌; 习杰英; 李静; 张海涛
    • 摘要: 目的:观察非血缘异基因造血干细胞移植治疗白血病的临床疗效及并发症。方法回顾性分析21例非血缘异基因造血干细胞移植的恶性血液病患者临床资料,其中19例为外周血造血干细胞移植,1例为骨髓移植,1例为脐血移植。HLA 全相合8例,HLA 不全相合13例。回输单个核细胞(MNC)中位数9.078×108/kg,CD34+细胞中位数4.62×106/kg。10例患者采用 BuCy 方案预处理,9例采用改良的 BuCy2方案预处理,1例采用非清髓的 BuCy+氟达拉滨的方案,1例采用 TBI+VP-16+CTX+meCCNU 预处理。预防移植物抗宿主病方案,其中20例采用短程甲氨蝶呤+环孢素 A+霉酚酸酯+抗胸腺细胞免疫球蛋白的四联方案,1例脐血移植患者采用短程甲氨蝶呤+环孢素 A +抗胸腺细胞免疫球蛋白。术后观察受者的造血重建、并发症以及预后情况。采用低剂量肝素+前列腺素 E1+丹参注射液预防肝静脉闭塞病(VOD)。结果除 1例患者于空髓期死于颅内出血,其余20例患者均获造血重建。高剂量组MNC 及 CD34+细胞较低剂量组中位重建时间平均缩短1 d。预处理中出现高热、寒战、胃肠道副反应、肝脏损伤及口腔黏膜炎等副反应,均给予对症处理后好转。HLA 不合者较 HLA 全相合者移植后移植物抗宿主病(GVHD)发生率高,差异有统计学意义。9例患者出现 aGVHD(Ⅰ度 3例,Ⅱ度4例,Ⅲ度2例);9例出现 cGVHD,表现为皮肤及肝脏受损,经有效治疗后好转。术后100 d 内18例受者出现细菌或真菌感染,以上呼吸道感染为主,7例发生巨细胞病毒感染,2例出现 EB 病毒血症,1例出现尿 BK 病毒感染。1例患者因 VOD 死亡,其余患者均未发生 VOD。5例发生Ⅱ级至Ⅲ级出血性膀胱炎,经治疗后均好转。受者总的中位生存时间为24月(136 d~9年),1年及3年总生存率分别为85.2%和63.9%,无病生存率分别为81.0%和23.8%,无复发生存率为71.4%和14.3%。结论非血缘异基因造血干细胞移植是治疗白血病的有效方法;BuCy 及改良 BuCy2的预处理方案均安全有效,毒性反应可逆、可耐受;高剂量 MNC 及 CD34+细胞数组造血重建时间较低剂量组缩短;HLA 不全相合者移植后 GVHD 发生率较 HLA 全相合者增高;低剂量肝素+前列腺素 E1+丹参注射液可有效预防 VOD。%non-myeloablative BuCy+fludarabine conditioning regimen,and another one was treated with TBI+VP-1 6 +CTX+CCNU conditioning regimen.Only one case received short-term MTX,cyclosporin A and ATG regimen for prevention of graft-versus-host disease (GVHD).The GVHD prevention regimens of the other patients were based on short-term MTX,cyclosporin A,ATG and mycophenolate mofetil regimen.The hematopoietic reconstitution, complications and prognosis were observed.Results One patient died of intracranial hemorrhage,and hematopoi-etic reconstitution was achieved in the other 20 patients.The median time for hematopoietic reconstitution shortened by one day in large-dose group compared with that in low-dose group.Adverse reactions included high fever, shivering,gastrointestinal tract adverse reaction,liver injury,oral mucositis and other rare side effects.GVHD occurred more frequently in patients with HLA mismatched transplantation.Nine patients with aGVHD and 9 patients with cGVHD recovered after effective treatment.Within 100 days after transplantation,18 patients had bacterial or fungal infection,mainly upper respiratory tract infection;7 patients had cytomegalovirus infection;2 had EB viremia,and one had urinary BK virus infection.Only one patient died of VOD.Hemorrhagic cystitis occurred in 5 patients and improved after treatment.The median survival time was 24 months (ranging from 136 days to 9 years).One-year and 3-year overall survival rates were 85.2% and 63.9%,the disease free survival rates were 81% and 23.8%,recurrence free survival rates were 71.4% and 14.3%,respectively.Conclusion URD-HSCT was an effective method to treat leukemia.Conditioning regimen of BuCy and modified BuCy2 were safe and effective,the adverse reactions were reversible and well tolerated.Hematopoietic reconstitution time shortened in large-dose MNC and CD34 + cell number groups compared with that in low-dose group.The occurrence rate of GVHD with HLA mismatched transplantation was more than that of HLA matched transplantation.Low-dose heparin,prostaglandin E1 and Danshen injection can effectively prevent VOD.
    • 吴进燕; 刘迷迷; 黄玉金; 化静; 徐开林; 曾令宇
    • 摘要: Objective To explore the role of nuclear factor (NF)-κB signal pathway in the process of hepatic veno-occlusive disease (HVOD) after allogeneic bone marrow transplantation (allo-BMT) in mice.Methods A total of 50 male BALB/c(H-2Kd)mice aged 8-10 weeks were included in this study.First,all mice were pretreated with lethal dose of total body irradiation (TBI).Then according to different transplant program,these mice were divided into bone marrow transplantutaion (BMT) group (n=20) and bone marrow joint endothelial progenitor cells (EPC) transplantion group (EPC group) (n =20).The TBI control group (n=5) and normal control group (n=5) were also set up.Liver function and the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in serum were detected on day 7,15,33 after transplantation,and the histological changes of hepatocytes were evaluated by hematoxylin-eosin (HE) staining and Masson staining.Pathological changes in the liver of mice were observed by microscope.Then the activation of the NF-κB signal pathway was detected by quantitative polymerase chain reaction and Western blot.Results ①After the transplant,AST,ALT and TBIL levels in EPC group recipient mice were significantly lower,compared with BMT group.The differences between BMT and EPC group were statistically significant (P < 0.05).② The concentration of TNF-α in EPC group was (138.73 ± 10.42) pg/mL,which was higher than (95.31 ±19.09) pg/mL in BMT group,on the 7th days after transplantation,but concentration of IL-6 in EPC group [(169.50 ±10.21)] pg/mL was lower than that in BMT group [(95.31±19.09) pg/mL].The differences between BMT and EPC group were statistically significant (t=6.907,-6.372; P<0.05).On the 15th day after transplantation,the concentration of IL-6 in EPC group was significantly elevated to (201.49± 14.97) pg/mL,which was higher than (151.51 ±26.43) pg/mL in the BMT group,the difference between the two groups was statistically significant (t 5.51,P<0.05).③On the 33th day after transplantation,the transforming growth factor (TG-F)-β,CXCL2,CCL2 and CCR2 levels of EPC group were significantly lower than BMT group,these indicators between BMT and ECP group were statistically significant differences (P<0.05).④The expression of IKKβ in NF-κB signal pathway peaked on the 15th day.The activation of IKKβ,phosphorylation of Iκβα and activation of P65 were consistent with the expression of IKKβ.Conclusions Activation of NF-κB signal pathway may promote the repair of damaged hepatocytes in early stage of allo-BMT complicating HVOD mice,but NF-κB signal pathway sustained activation may promote the formation of liver fibrosis after the restore of impaired cells.%目的 探讨核因子(NF)-κB信号通路在异基因骨髓移植(allo-BMT)后并发肝静脉闭塞病(H VOD)中的作用.方法 选择50只8~10周龄雄性BALB/c(H-2Kd)小鼠作为研究对象.小鼠经致死剂量全身照射(TBI)预处理后,根据移植方案不同,将其分为骨髓移植(BMT)组(n=20)和骨髓联合内皮祖细胞(EPC)移植组(EPC组)(n=20);另设TBI对照组(n=5)和正常对照组(n=5)(实验过程中对动物的处置符合动物伦理学标准).于移植后7d、15d和33 d,检测移植后受鼠肝功能及血清肿瘤坏死因子(TNF)-α及白细胞介素(IL)-6水平.受鼠肝脏组织经苏木精-伊红(HE)染色法及Masson染色法染色后,光镜下观察小鼠肝脏的病理改变.荧光定量聚合酶链反应及Western免疫印迹法(WB)法检测受鼠肝细胞内NF-κB信号通路的活化情况.结果 ①移植后,EPC组受鼠与BMT组相比,天冬氨酸转氨酶、丙氨酸转氨酶和总胆红素水平明显降低,两组比较,差异有统计学意义(P<0.05).②移植后第7天,EPC组受鼠TNF-α表达量为(138.73±10.42)pg/mL,显著高于BMT组的(95.31±19.09) pg/mL,两组相比,差异有统计学意义(t=6.907,P<0.05),而IL-6的表达量为(169.50±10.21) pg/mL,低于BMT组的(215.01±22.13)pg/mL,两组比较,差异有统计学意义(t=-6.372,P<0.05);第15天EPC组受鼠的IL-6水平升高至(201.49±14.97) pg/mL,明显高于BMT组的(151.51±26.43) pg/mL,两组比较,差异有统计学意义(t=5.51,P<0.05).③移植后第33天,EPC组受鼠转化生长因子(TGF)-β、CXCL2、CCL2和CCR2水平均较BMT组明显降低,两组上述各项指标比较,差异均有统计学意义(P<0.05).④移植后小鼠肝细胞内NF-κB信号通路相关分子IKKβ于移植后第15天达峰值.IKKβ的活化、IκBα的磷酸化及P65的活化水平与IKKβ的表达水平一致.结论 allo-BMT并发HVOD受鼠早期肝细胞内NF-κB信号通路的活化,可促进损伤肝细胞的修复,但在肝细胞修复后,NF-κB信号通路的持续活化可促进肝纤维化.
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